Electrosurgical Pericardial Puncture

Abstract

Devices and methods for providing access to the pericardial cavity while reducing risk of myocardial damage. One method comprises the steps of: (a) advancing a puncture device towards a heart, the puncture device including an energy delivery device at a distal end of the puncture device; (b) delivering a single pulse of a pulsed energy through the energy delivery device to a parietal pericardium of the heart to create a void relatively close to the energy delivery device while maintaining the distal end of the puncture device in a substantially stationary position relative to the parietal pericardium; (c) advancing the puncture device a short distance into the void; (d) checking if the puncture device has accessed the pericardial cavity by measuring pressure on the distal end of the puncture device; and (e) repeating steps (b), (c), and (d), if necessary, until the energy delivery device is located at least partially within the pericardial cavity. The methods may include a step of confirming that the puncture device is at least partially within the parietal cavity by injecting or aspirating fluid through a lumen in the puncture device or measuring the pressure or electrical impedance at the distal end of the puncture device.

Description

CROSS-REFERENCES TO RELATED APPLICATIONS[0001]The present application is a continuation-in-part of U.S. application Ser. No. 16 / 124,684, filed Sep. 7, 2018, which is a continuation of U.S. application Ser. No. 14 / 933,356, filed Nov. 5, 2015, which is a continuation-in-part of U.S. application Ser. No. 14 / 257,053, filed Apr. 12, 2014, which is a continuation-in part of U.S. application Ser. No. 13 / 656,173, filed Oct. 19, 2012, issued as U.S. Pat. No. 8,702,692 which is a continuation-in-part of U.S. application Ser. No. 12 / 005,316, filed Dec. 27, 2007, issued as U.S. Pat. No. 8,308,720, which claims the benefit of U.S. provisional patent application 60 / 883,074, filed on Jan. 2, 2007. All of the aforementioned applications and patents are hereby incorporated by reference in their entirety.TECHNICAL FIELD[0002]The present invention relates to methods for treating the heart of a patient. More specifically, the present invention relates to methods of accessing the pericardial cavity of a...

AI Technical Summary

Benefits of technology

The patent describes a method for accessing the pericardial cavity of a heart while reducing the risk of damaging the myocardium layer. The method involves advancing a puncture device with an energy delivery device at its distal end towards the heart. The energy delivery device delivers a single pulse of pulsed energy to create a void in the pericardium, while the puncture device is stationary. The puncture device is then advanced into the void and the pressure on its distal end is measured. The process is repeated until the energy delivery device is located at least partially within the pericardial cavity. The method can be used with different types of energy delivery devices, such as pulsed optical energy, DC electrical energy, or bipolar energy delivery. The method can also be used with contrast fluid or aspirating fluid. Medical imaging can be used to visualize the position of the puncture device or the energy delivery device. The technical effect of the patent is to provide a safe and effective method for accessing the pericardial cavity while minimizing damage to the heart.

Problems solved by technology

This technique, however, has various risks associated with it, the most notable of which is the laceration of the myocardium by the needle.

This risk is heightened in cases where the pericardial cavity and fluid volume is small.

The prior art includes alternative methods of accessing the pericardial cavity, but the methods described are relatively invasive and carry further risks to the patient.

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